Individual provider Active NPI

Charles Alfred Scogno, M.D.

  • Family Medicine Physician
  • Lebanon, PA
National Provider Identifier
1427066034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-062235-L Issued in PA
Practice address
1700 S Lincoln Ave
Lebanon, PA 17042-7529
Phone
(717) 272-6621
Fax
(717) 228-6156
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-062235-L PA Primary

Addresses

Primary practice location

1700 S Lincoln Ave
Lebanon, PA 17042-7529

Mailing address

63 Truman St
Palmyra, PA 17078-2951
Phone (717) 832-0152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120921000474 PA Order and Referring Only - Family PracticePractitioner - Family Practice 7315131562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-062235-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Physician Services Past Accepting new patients
Lebanon Valley Family Medicine Inc Past Accepting new patients
Good Samaritian Physician Services Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427066034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 TRUMAN ST",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170782951",
            "telephone_number": "717-832-0152",
            "fax_number": "717-228-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427529",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOGNO",
        "first_name": "CHARLES",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-062235-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.